Delta Presents Named Scholarship Form

Delta Presents Program - Named Scholarship Form

NOTE: a minimum donation amount of $250 is required:
Name of Contact Person*

First NameLast Name
Title*
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Indicate the scholarship amount:*

$250Other
Provide the specific name of the scholarship to be used in the event materials.*
Provide a brief description of the purpose of the scholarship to be used in the event materials.*

0/250
Payment Information:*

Invoice meCheck (Make payable to Delta Presents Outreach Foundation - P.O. Box 24636 Little Rock, AR 72221-4636)In-Person
Donor Agreement:

By submitting this form, the donor agrees to commits to providing a minimum donation amount of $250 and to deliver the selected donation amount by February 15, 2025. Additionally, the organizer reserves the right to allocate benefits based on the payment received.
Authorized Signature: *

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Should be Empty: